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1.
Brain ; 142(7): 2037-2050, 2019 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-31505548

RESUMEN

Freezing of gait is a disabling symptom of Parkinson's disease that causes a paroxysmal inability to generate effective stepping. The underlying pathophysiology has recently migrated towards a dysfunctional supraspinal locomotor network, but the actual network derangements during ongoing gait freezing are unknown. We investigated the communication between the cortex and the subthalamic nucleus, two main nodes of the locomotor network, in seven freely-moving subjects with Parkinson's disease with a novel deep brain stimulation device, which allows on-demand recording of subthalamic neural activity from the chronically-implanted electrodes months after the surgical procedure. Multisite neurophysiological recordings during (effective) walking and ongoing gait freezing were combined with kinematic measurements and individual molecular brain imaging studies. Patients walked in a supervised environment closely resembling everyday life challenges. We found that during (effective) walking, the cortex and subthalamic nucleus were synchronized in a low frequency band (4-13 Hz). In contrast, gait freezing was characterized in every patient by low frequency cortical-subthalamic decoupling in the hemisphere with less striatal dopaminergic innervation. Of relevance, this decoupling was already evident at the transition from normal (effective) walking into gait freezing, was maintained during the freezing episode, and resolved with recovery of the effective walking pattern. This is the first evidence for a decoding of the networked processing of locomotion in Parkinson's disease and suggests that freezing of gait is a 'circuitopathy' related to a dysfunctional cortical-subcortical communication. A successful therapeutic approach for gait freezing in Parkinson's disease should aim at directly targeting derangements of neural network dynamics.


Asunto(s)
Corteza Cerebral/fisiopatología , Trastornos Neurológicos de la Marcha/fisiopatología , Enfermedad de Parkinson/fisiopatología , Núcleo Subtalámico/fisiopatología , Electrodos Implantados , Femenino , Trastornos Neurológicos de la Marcha/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Vías Nerviosas/fisiopatología , Enfermedad de Parkinson/complicaciones , Caminata
2.
Eur J Neurosci ; 48(6): 2362-2373, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-30117212

RESUMEN

Levodopa-induced dyskinesias are a common and disabling side effect of dopaminergic therapy in Parkinson's disease, but their neural mechanisms in vivo are still poorly understood. Besides striatal pathology, the importance of cortical dysfunction has been increasingly recognized. The supplementary motor area in particular, may have a relevant role in dyskinesias onset given its involvement in endogenously generated actions. The aim of the present study was to investigate the levodopa-related cortical excitability changes along with the emergence of levodopa-induced peak-of-dose dyskinesias in subjects with Parkinson's disease. Thirteen patients without dyskinesias and ten with dyskinesias received 200/50 mg fast-acting oral levodopa/benserazide following overnight withdrawal (12 hr) from their dopaminergic medication. We targeted transcranial magnetic stimulation to the supplementary motor area, ipsilateral to the most dopamine-depleted striatum defined with single-photon emission computed tomography with [123 I]N-ω-fluoropropyl-2ß-carbomethoxy-3ß-(4-iodophenyl)nortropane, and recorded transcranial magnetic stimulation-evoked potentials with high-density electroencephalography before and at 30, 60, and 180 min after levodopa/benserazide intake. Clinical improvement from levodopa/benserazide paralleled the increase in cortical excitability in both groups. Subjects with dyskinesias showed higher fluctuation of cortical excitability in comparison to non-dyskinetic patients, possibly reflecting dyskinetic movements. Together with endogenous brain oscillation, levodopa-related dynamics of brain state could influence the therapeutic response of neuromodulatory interventions.


Asunto(s)
Antiparkinsonianos/uso terapéutico , Benserazida/farmacología , Levodopa/farmacología , Enfermedad de Parkinson/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , Encéfalo/efectos de los fármacos , Encéfalo/fisiopatología , Combinación de Medicamentos , Discinesia Inducida por Medicamentos/tratamiento farmacológico , Electroencefalografía/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Corteza Motora/fisiopatología , Enfermedad de Parkinson/fisiopatología , Estimulación Magnética Transcraneal/métodos
3.
BMC Bioinformatics ; 18(1): 124, 2017 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-28231759

RESUMEN

BACKGROUND: In the evaluation of Stereo-Electroencephalography (SEEG) signals, the physicist's workflow involves several operations, including determining the position of individual electrode contacts in terms of both relationship to grey or white matter and location in specific brain regions. These operations are (i) generally carried out manually by experts with limited computer support, (ii) hugely time consuming, and (iii) often inaccurate, incomplete, and prone to errors. RESULTS: In this paper we present SEEG Assistant, a set of tools integrated in a single 3DSlicer extension, which aims to assist neurosurgeons in the analysis of post-implant structural data and hence aid the neurophysiologist in the interpretation of SEEG data. SEEG Assistant consists of (i) a module to localize the electrode contact positions using imaging data from a thresholded post-implant CT, (ii) a module to determine the most probable cerebral location of the recorded activity, and (iii) a module to compute the Grey Matter Proximity Index, i.e. the distance of each contact from the cerebral cortex, in order to discriminate between white and grey matter location of contacts. Finally, exploiting 3DSlicer capabilities, SEEG Assistant offers a Graphical User Interface that simplifies the interaction between the user and the tools. SEEG Assistant has been tested on 40 patients segmenting 555 electrodes, and it has been used to identify the neuroanatomical loci and to compute the distance to the nearest cerebral cortex for 9626 contacts. We also performed manual segmentation and compared the results between the proposed tool and gold-standard clinical practice. As a result, the use of SEEG Assistant decreases the post implant processing time by more than 2 orders of magnitude, improves the quality of results and decreases, if not eliminates, errors in post implant processing. CONCLUSIONS: The SEEG Assistant Framework for the first time supports physicists by providing a set of open-source tools for post-implant processing of SEEG data. Furthermore, SEEG Assistant has been integrated into 3D Slicer, a software platform for the analysis and visualization of medical images, overcoming limitations of command-line tools.


Asunto(s)
Epilepsia/cirugía , Imagenología Tridimensional , Interfaz Usuario-Computador , Adulto , Encéfalo/diagnóstico por imagen , Mapeo Encefálico , Electrodos Implantados , Electroencefalografía , Epilepsia/patología , Femenino , Humanos
5.
Front Bioeng Biotechnol ; 12: 1285107, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38638317

RESUMEN

Immersive technology, such as extended reality, holds promise as a tool for educating ophthalmologists about the effects of low vision and for enhancing visual rehabilitation protocols. However, immersive simulators have not been evaluated for their ability to induce changes in the oculomotor system, which is crucial for understanding the visual experiences of visually impaired individuals. This study aimed to assess the REALTER (Wearable Egocentric Altered Reality Simulator) system's capacity to induce specific alterations in healthy individuals' oculomotor systems under simulated low-vision conditions. We examined task performance, eye movements, and head movements in healthy participants across various simulated scenarios. Our findings suggest that REALTER can effectively elicit behaviors in healthy individuals resembling those observed in individuals with low vision. Participants with simulated binocular maculopathy demonstrated unstable fixations and a high frequency of wide saccades. Individuals with simulated homonymous hemianopsia showed a tendency to maintain a fixed head position while executing wide saccades to survey their surroundings. Simulation of tubular vision resulted in a significant reduction in saccade amplitudes. REALTER holds promise as both a training tool for ophthalmologists and a research instrument for studying low vision conditions. The simulator has the potential to enhance ophthalmologists' comprehension of the limitations imposed by visual disabilities, thereby facilitating the development of new rehabilitation protocols.

6.
Sci Rep ; 13(1): 7445, 2023 05 08.
Artículo en Inglés | MEDLINE | ID: mdl-37156822

RESUMEN

Contrary to a photographer, who puts a great effort in keeping the lens still, eyes insistently move even during fixation. This benefits signal decorrelation, which underlies an efficient encoding of visual information. Yet, camera motion is not sufficient alone; it must be coupled with a sensor specifically selective to temporal changes. Indeed, motion induced on standard imagers only results in burring effects. Neuromorphic sensors represent a valuable solution. Here we characterize the response of an event-based camera equipped with fixational eye movements (FEMs) on both synthetic and natural images. Our analyses prove that the system starts an early stage of redundancy suppression, as a precursor of subsequent whitening processes on the amplitude spectrum. This does not come at the price of corrupting structural information contained in local spatial phase across oriented axes. Isotropy of FEMs ensures proper representations of image features without introducing biases towards specific contrast orientations.


Asunto(s)
Fijación Ocular , Movimientos Oculares , Movimiento (Física) , Visión Ocular
7.
Front Neurol ; 13: 801142, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35265025

RESUMEN

Postural control is a complex sensorimotor skill that is fundamental to our daily life. The abilities to maintain and recover balance degrade with age. However, the time decay of balance performance with age is not well understood. In this study, we aim at quantifying the age-dependent changes in standing balance under static and dynamic conditions. We tested 272 healthy subjects with ages ranging from 20 to 90. Subjects maintained the upright posture while standing on the robotic platform hunova®. In the evaluation of static balance, subjects stood on the fixed platform both with eyes open (EO) and eyes closed (EC). In the dynamic condition, subjects stood with eyes open on the moving foot platform that provided three different perturbations: (i) an inclination proportional to the center of pressure displacements, (ii) a pre-defined predictable motion, and (iii) an unpredictable and unexpected tilt. During all these tests, hunova® measured the inclination of the platform and the displacement of the center of pressure, while the trunk movements were recorded with an accelerometer placed on the sternum. To quantify balance performance, we computed spatio-temporal parameters typically used in clinical environments from the acceleration measures: mean velocity, variability of trunk motion, and trunk sway area. All subjects successfully completed all the proposed exercises. Their motor performance in the dynamic balance tasks quadratically changed with age. Also, we found that the reliance on visual feedback is not age-dependent in static conditions. All subjects well-tolerated the proposed protocol independently of their age without experiencing fatigue as we chose the timing of the evaluations based on clinical needs and routines. Thus, this study is a starting point for the definition of robot-based assessment protocols aiming at detecting the onset of age-related standing balance deficits and allowing the planning of tailored rehabilitation protocols to prevent falls in older adults.

8.
Front Hum Neurosci ; 16: 783452, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35399359

RESUMEN

Objective: Gait adaptation to environmental challenges is fundamental for independent and safe community ambulation. The possibility of precisely studying gait modulation using standardized protocols of gait analysis closely resembling everyday life scenarios is still an unmet need. Methods: We have developed a fully-immersive virtual reality (VR) environment where subjects have to adjust their walking pattern to avoid collision with a virtual agent (VA) crossing their gait trajectory. We collected kinematic data of 12 healthy young subjects walking in real world (RW) and in the VR environment, both with (VR/A+) and without (VR/A-) the VA perturbation. The VR environment closely resembled the RW scenario of the gait laboratory. To ensure standardization of the obstacle presentation the starting time speed and trajectory of the VA were defined using the kinematics of the participant as detected online during each walking trial. Results: We did not observe kinematic differences between walking in RW and VR/A-, suggesting that our VR environment per se might not induce significant changes in the locomotor pattern. When facing the VA all subjects consistently reduced stride length and velocity while increasing stride duration. Trunk inclination and mediolateral trajectory deviation also facilitated avoidance of the obstacle. Conclusions: This proof-of-concept study shows that our VR/A+ paradigm effectively induced a timely gait modulation in a standardized immersive and realistic scenario. This protocol could be a powerful research tool to study gait modulation and its derangements in relation to aging and clinical conditions.

9.
Sleep ; 45(1)2022 01 11.
Artículo en Inglés | MEDLINE | ID: mdl-34551110

RESUMEN

STUDY OBJECTIVES: Increased phase synchronization in electroencephalography (EEG) bands might reflect the activation of compensatory mechanisms of cognitive decline in people with neurodegenerative diseases. Here, we investigated whether altered large-scale couplings of brain oscillations could be linked to the balancing of cognitive decline in a longitudinal cohort of people with idiopathic rapid eye-movement sleep behavior disorder (iRBD). METHODS: We analyzed 18 patients (17 males, 69.7 ± 7.5 years) with iRBD undergoing high-density EEG (HD-EEG), presynaptic dopaminergic imaging, and clinical and neuropsychological (NPS) assessments at two time points (time interval 24.2 ± 5.9 months). We thus quantified the HD-EEG power distribution, orthogonalized amplitude correlation, and weighted phase-lag index at both time points and correlated them with clinical, NPS, and imaging data. RESULTS: Four patients phenoconverted at follow-up (three cases of parkinsonism and one of dementia). At the group level, NPS scores decreased over time, without reaching statistical significance. However, alpha phase synchronization increased and delta amplitude correlations decreased significantly at follow-up compared to baseline. Both large-scale network connectivity metrics were significantly correlated with NPS scores but not with sleep quality indices or presynaptic dopaminergic imaging data. CONCLUSIONS: These results suggest that increased alpha phase synchronization and reduced delta amplitude correlation may be considered electrophysiological signs of an active compensatory mechanism of cognitive impairment in people with iRBD. Large-scale functional modifications may be helpful biomarkers in the characterization of prodromal stages of alpha-synucleinopathies.


Asunto(s)
Trastorno de la Conducta del Sueño REM , Encéfalo , Progresión de la Enfermedad , Electroencefalografía , Humanos , Masculino , Sueño
10.
J Neural Eng ; 18(4)2021 08 31.
Artículo en Inglés | MEDLINE | ID: mdl-34388744

RESUMEN

Objective. Technical advances in deep brain stimulation (DBS) are crucial to improve therapeutic efficacy and battery life. We report the potentialities and pitfalls of one of the first commercially available devices capable of recording brain local field potentials (LFPs) from the implanted DBS leads, chronically and during stimulation. The aim was to provide clinicians with well-grounded tips on how to maximize the capabilities of this novel device, both in everyday practice and for research purposes.Approach. We collected clinical and neurophysiological data of the first 20 patients (14 with Parkinson's disease (PD), five with dystonia, one with chronic pain) that received the Percept™ PC in our centres. We also performed tests in a saline bath to validate the recordings quality.Main results. The Percept PC reliably recorded the LFP of the implanted site, wirelessly and in real time. We recorded the most promising clinically useful biomarkers for PD and dystonia (beta and theta oscillations) with and without stimulation. Furthermore, we provide an open-source code to facilitate export and analysis of data. Critical aspects of the system are presently related to contact selection, artefact detection, data loss, and synchronization with other devices.Significance. New technologies will soon allow closed-loop neuromodulation therapies, capable of adapting stimulation based on real-time symptom-specific and task-dependent input signals. However, technical aspects need to be considered to ensure reliable recordings. The critical use by a growing number of DBS experts will alert new users about the currently observed shortcomings and inform on how to overcome them.


Asunto(s)
Estimulación Encefálica Profunda , Enfermedad de Parkinson , Artefactos , Encéfalo , Humanos , Enfermedad de Parkinson/diagnóstico , Enfermedad de Parkinson/terapia
11.
Brain Stimul ; 13(6): 1743-1752, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32961337

RESUMEN

BACKGROUND: Abnormal beta band activity in the subthalamic nucleus (STN) is known to be exaggerated in patients with Parkinson's disease, and the amplitude of such activity has been associated with akinetic rigid symptoms. New devices for deep brain stimulation (DBS) that operate by adapting the stimulation parameters generally rely on the detection of beta activity amplitude modulations in these patients. Movement-related frequency modulation of beta oscillatory activity has been poorly investigated, despite being an attractive variable for extracting information about basal ganglia activity. OBJECTIVE: We studied the STN oscillatory activity associated with locomotion and proposed a new approach to extract movement related information from beta band activity. METHODS: We recorded bilateral local field potential of the STN in eight parkinsonian patients implanted with DBS electrodes during upright quiet standing and unperturbed walking. Neurophysiological recordings were combined with kinematic measurements and individual molecular brain imaging studies. We then determined the information carried by the STN oscillatory activity about locomotion and we identified task-specific biomarkers. RESULTS: We found a gait-related peak frequency modulation of the beta band of STN recordings of parkinsonian patients. This novel biomarker and the associated power modulations were highly informative to detect the walking state (with respect to standing) in each single patient. CONCLUSION: Frequency modulation in the human STN represents a fundamental aspect of information processing of locomotion. Our information-driven approach could significantly enrich the spectrum of Parkinson's neural markers, with input signals encoding ongoing tasks execution for an appropriate online tuning of DBS delivery.


Asunto(s)
Ritmo beta/fisiología , Estimulación Encefálica Profunda/métodos , Marcha/fisiología , Enfermedad de Parkinson/terapia , Núcleo Subtalámico/fisiología , Anciano , Estimulación Encefálica Profunda/tendencias , Femenino , Humanos , Masculino , Persona de Mediana Edad , Movimiento/fisiología , Enfermedad de Parkinson/fisiopatología
12.
Artículo en Inglés | MEDLINE | ID: mdl-32154229

RESUMEN

Maintaining balance standing upright is an active process that complements the stabilizing properties of muscle stiffness with feedback control driven by independent sensory channels: proprioceptive, visual, and vestibular. Considering that the contribution of these channels is additive, we investigated to what extent providing an additional channel, based on vibrotactile stimulation, may improve balance control. This study focused only on healthy young participants for evaluating the effects of different encoding methods and the importance of the informational content. We built a device that provides a vibrotactile feedback using two vibration motors placed on the anterior and posterior part of the body, at the L5 level. The vibration was synchronized with an accelerometric measurement encoding a combination of the position and acceleration of the body center of mass in the anterior-posterior direction. The goal was to investigate the efficacy of the information encoded by this feedback in modifying postural patterns, comparing, in particular, two different encoding methods: vibration always on and vibration with a dead zone, i.e., silent in a region around the natural stance posture. We also studied if after the exposure, the participants modified their normal oscillation patterns, i.e., if there were after effects. Finally, we investigated if these effects depended on the informational content of the feedback, introducing trials with vibration unrelated to the actual postural oscillations (sham feedback). Twenty-four participants were asked to stand still with their eyes closed, alternating trials with and without vibrotactile feedback: nine were tested with vibration always on and sham feedback, fifteen with dead zone feedback. The results show that synchronized vibrotactile feedback reduces significantly the sway amplitude while increasing the frequency in anterior-posterior and medial-lateral directions. The two encoding methods had no different effects of reducing the amount of postural sway during exposure to vibration, however only the dead-zone feedback led to short-term after effects. The presence of sham vibration, instead, increased the sway amplitude, highlighting the importance of the encoded information.

13.
Ann Clin Transl Neurol ; 7(4): 579-583, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32162447

RESUMEN

Pathophysiological understanding of gait and balance disorders in Parkinson's disease is insufficient and late recognition of fall risk limits efficacious follow-up to prevent or delay falls. We show a distinctive reduction of glucose metabolism in the left posterior parietal cortex, with increased metabolic activity in the cerebellum, in parkinsonian patients 6-8 months before their first fall episode. Falls in Parkinson's disease may arise from altered cortical processing of body spatial orientation, possibly predicted by abnormal cortical metabolism.


Asunto(s)
Accidentes por Caídas , Cerebelo/metabolismo , Glucosa/metabolismo , Lóbulo Parietal/metabolismo , Enfermedad de Parkinson/metabolismo , Enfermedad de Parkinson/fisiopatología , Anciano , Cerebelo/diagnóstico por imagen , Femenino , Fluorodesoxiglucosa F18/farmacocinética , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Lóbulo Parietal/diagnóstico por imagen , Tomografía de Emisión de Positrones , Radiofármacos/farmacocinética
14.
Artículo en Inglés | MEDLINE | ID: mdl-32211390

RESUMEN

Postural instability, in particular at gait initiation (GI), and resulting falls are a major determinant of poor quality of life in subjects with Parkinson's disease (PD). Still, the contribution of the basal ganglia and dopamine on the feedforward postural control associated with this motor task is poorly known. In addition, the influence of anthropometric measures (AM) and initial stance condition on GI has never been consistently assessed. The biomechanical resultants of anticipatory postural adjustments contributing to GI [imbalance (IMB), unloading (UNL), and stepping phase) were studied in 26 unmedicated subjects with idiopathic PD and in 27 healthy subjects. A subset of 13 patients was analyzed under standardized medication conditions and the striatal dopaminergic innervation was studied in 22 patients using FP-CIT and SPECT. People with PD showed a significant reduction in center of pressure (CoP) displacement and velocity during the IMB phase, reduced first step length and velocity, and decreased velocity and acceleration of the center of mass (CoM) at toe off of the stance foot. All these measurements correlated with the dopaminergic innervation of the putamen and substantially improved with levodopa. These results were not influenced by anthropometric parameters or by the initial stance condition. In contrast, most of the measurements of the UNL phase were influenced by the foot placement and did not correlate with putaminal dopaminergic innervation. Our results suggest a significant role of dopamine and the putamen particularly in the elaboration of the IMB phase of anticipatory postural adjustments and in the execution of the first step. The basal ganglia circuitry may contribute to defining the optimal referent body configuration for a proper initiation of gait and possibly gait adaptation to the environment.

15.
IEEE Int Conf Rehabil Robot ; 2019: 570-576, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31374691

RESUMEN

Postural responses to unstable conditions or perturbations are important predictors of the risk of falling and can reveal balance deficits in people with neurological disorders, such as Parkinson's Disease (PD). However, there is a lack of evidences related to devices and protocols providing a comprehensive and quantitative evaluation of postural responses in different stability conditions. We tested ten people with PD and ten controls on a robotic platform capable to provide different mechanical interactions and to measure the center of pressure displacement, while trunk acceleration was recorded with a sensor placed on the sternum. We evaluated performance while maintaining upright posture in unperturbed, perturbed, and unstable conditions. The latter was tested while standing and sitting. We measured whether the proposed exercises and metrics could highlight differences in postural control. Participants with PD had worse performance metrics when standing under unperturbed or unstable conditions, and when sitting on the unstable platform. PD subjects in response to a forward perturbation showed bigger trunk oscillations coupled with a sharper increase of the CoP backward displacement. These responses could be due to higher stiffness of lower limb which leads to postural instability. The exercises and the proposed metrics highlighted differences in postural control, hence they can be used in clinical environment for the assessment and progression of postural impairments.


Asunto(s)
Enfermedad de Parkinson/fisiopatología , Equilibrio Postural , Robótica , Sedestación , Posición de Pie , Accidentes por Caídas/prevención & control , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad
16.
Clin Biomech (Bristol, Avon) ; 63: 140-146, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30889433

RESUMEN

BACKGROUND: Falls are one of the main concerns in people with Parkinson's disease, leading to poor quality of life and increased mortality. The sit-to-walk movement is the most frequent postural transition task during daily life and is highly demanding in terms of balance maintenance and muscular strength. METHODS: With the aim of identifying biomechanical variables of high risk of falling, we investigated the sit-to-walk task performed by 9 Parkinson's disease patients with at least one fall episode in the six months preceding this study, 15 Parkinson's disease patients without previous falls, and 20 healthy controls. Motor performance was evaluated with an optoelectronic system and two dynamometric force plates after overnight suspension of all dopaminergic drugs and one hour after consumption of a standard dose of levodopa/benserazide. FINDINGS: Poor trunk movements critically influenced the execution of the sit-to-walk movement in patients with a history of falling. The peak velocity of the trunk in the anterior-posterior direction discriminated faller from non-faller patients, with high specificity and sensitivity in both the medication-off and -on state. INTERPRETATION: Our results confirm the difficulties in merging consecutive motor tasks in patients with Parkinson's disease. Trunk movements during the sit-to-walk can provide valuable measurements to monitor and possibly predict the risk of falling.


Asunto(s)
Accidentes por Caídas/prevención & control , Enfermedad de Parkinson/fisiopatología , Equilibrio Postural , Sedestación , Caminata , Anciano , Anciano de 80 o más Años , Benserazida/administración & dosificación , Estudios de Casos y Controles , Combinación de Medicamentos , Femenino , Humanos , Levodopa/administración & dosificación , Masculino , Persona de Mediana Edad , Movimiento , Calidad de Vida , Sensibilidad y Especificidad
17.
PLoS One ; 13(6): e0198691, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29874298

RESUMEN

The role of the subthalamic nucleus in human locomotion is unclear although relevant, given the troublesome management of gait disturbances with subthalamic deep brain stimulation in patients with Parkinson's disease. We investigated the subthalamic activity and inter-hemispheric connectivity during walking in eight freely-moving subjects with Parkinson's disease and bilateral deep brain stimulation. In particular, we compared the subthalamic power spectral densities and coherence, amplitude cross-correlation and phase locking value between resting state, upright standing, and steady forward walking. We observed a phase locking value drop in the ß-frequency band (≈13-35Hz) during walking with respect to resting and standing. This modulation was not accompanied by specific changes in subthalamic power spectral densities, which was not related to gait phases or to striatal dopamine loss measured with [123I]N-ω-fluoropropyl-2ß-carbomethoxy-3ß-(4-iodophenyl)nortropane and single-photon computed tomography. We speculate that the subthalamic inter-hemispheric desynchronization in the ß-frequency band reflects the information processing of each body side separately, which may support linear walking. This study also suggests that in some cases (i.e. gait) the brain signal, which could allow feedback-controlled stimulation, might derive from network activity.


Asunto(s)
Estimulación Encefálica Profunda , Marcha/fisiología , Red Nerviosa/fisiología , Enfermedad de Parkinson/terapia , Núcleo Subtalámico/fisiología , Anciano , Retroalimentación Fisiológica , Femenino , Análisis de la Marcha/métodos , Humanos , Masculino , Persona de Mediana Edad , Neuronas/fisiología , Enfermedad de Parkinson/diagnóstico por imagen , Enfermedad de Parkinson/fisiopatología , Posición de Pie , Núcleo Subtalámico/citología , Núcleo Subtalámico/diagnóstico por imagen , Tomografía Computarizada de Emisión de Fotón Único , Estimulación Eléctrica Transcutánea del Nervio
18.
Sci Rep ; 7: 44800, 2017 03 20.
Artículo en Inglés | MEDLINE | ID: mdl-28317909

RESUMEN

Depth perception in near viewing strongly relies on the interpretation of binocular retinal disparity to obtain stereopsis. Statistical regularities of retinal disparities have been claimed to greatly impact on the neural mechanisms that underlie binocular vision, both to facilitate perceptual decisions and to reduce computational load. In this paper, we designed a novel and unconventional approach in order to assess the role of fixation strategy in conditioning the statistics of retinal disparity. We integrated accurate realistic three-dimensional models of natural scenes with binocular eye movement recording, to obtain accurate ground-truth statistics of retinal disparity experienced by a subject in near viewing. Our results evidence how the organization of human binocular visual system is finely adapted to the disparity statistics characterizing actual fixations, thus revealing a novel role of the active fixation strategy over the binocular visual functionality. This suggests an ecological explanation for the intrinsic preference of stereopsis for a close central object surrounded by a far background, as an early binocular aspect of the figure-ground segregation process.


Asunto(s)
Percepción de Profundidad , Disparidad Visual , Ambiente , Movimientos Oculares , Humanos , Visión Binocular
19.
Front Pediatr ; 5: 182, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28913326

RESUMEN

INTRODUCTION: Diffusion-weighted magnetic resonance imaging (DW-MRI) allows noninvasive investigation of brain structure in vivo. Diffusion tensor imaging (DTI) is a frequently used application of DW-MRI that assumes a single main diffusion direction per voxel, and is therefore not well suited for reconstructing crossing fiber tracts. Among the solutions developed to overcome this problem, constrained spherical deconvolution with probabilistic tractography (CSD-PT) has provided superior quality results in clinical settings on adult subjects; however, it requires particular acquisition parameters and long sequences, which may limit clinical usage in the pediatric age group. The aim of this work was to compare the results of DTI with those of track density imaging (TDI) maps and CSD-PT on data from neonates and children, acquired with low angular resolution and low b-value diffusion sequences commonly used in pediatric clinical MRI examinations. MATERIALS AND METHODS: We analyzed DW-MRI studies of 50 children (eight neonates aged 3-28 days, 20 infants aged 1-8 months, and 22 children aged 2-17 years) acquired on a 1.5 T Philips scanner using 34 gradient directions and a b-value of 1,000 s/mm2. Other sequence parameters included 60 axial slices; acquisition matrix, 128 × 128; average scan time, 5:34 min; voxel size, 1.75 mm × 1.75 mm × 2 mm; one b = 0 image. For each subject, we computed principal eigenvector (EV) maps and directionally encoded color TDI maps (DEC-TDI maps) from whole-brain tractograms obtained with CSD-PT; the cerebellar-thalamic, corticopontocerebellar, and corticospinal tracts were reconstructed using both CSD-PT and DTI. Results were compared by two neuroradiologists using a 5-point qualitative score. RESULTS: The DEC-TDI maps obtained presented higher anatomical detail than EV maps, as assessed by visual inspection. In all subjects, white matter (WM) tracts were successfully reconstructed using both tractography methodologies. The mean qualitative scores of all tracts obtained with CSD-PT were significantly higher than those obtained with DTI (p-value < 0.05 for all comparisons). CONCLUSION: CSD-PT can be successfully applied to DW-MRI studies acquired at 1.5 T with acquisition parameters adapted for pediatric subjects, thus providing TDI maps with greater anatomical detail. This methodology yields satisfactory results for clinical purposes in the pediatric age group.

20.
Sci Data ; 4: 170034, 2017 03 28.
Artículo en Inglés | MEDLINE | ID: mdl-28350382

RESUMEN

Binocular stereopsis is the ability of a visual system, belonging to a live being or a machine, to interpret the different visual information deriving from two eyes/cameras for depth perception. From this perspective, the ground-truth information about three-dimensional visual space, which is hardly available, is an ideal tool both for evaluating human performance and for benchmarking machine vision algorithms. In the present work, we implemented a rendering methodology in which the camera pose mimics realistic eye pose for a fixating observer, thus including convergent eye geometry and cyclotorsion. The virtual environment we developed relies on highly accurate 3D virtual models, and its full controllability allows us to obtain the stereoscopic pairs together with the ground-truth depth and camera pose information. We thus created a stereoscopic dataset: GENUA PESTO-GENoa hUman Active fixation database: PEripersonal space STereoscopic images and grOund truth disparity. The dataset aims to provide a unified framework useful for a number of problems relevant to human and computer vision, from scene exploration and eye movement studies to 3D scene reconstruction.


Asunto(s)
Algoritmos , Percepción de Profundidad , Humanos , Disparidad Visual
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